Does my child need therapy?
The American Pediatrics Association has developed guidelines to help parents and healthcare professionals determine whether therapeutic intervention is needed. Please use the guide below !
- Does not cry when hungry or uncomfortable
- Does not make comfort sounds or sucking sounds
- Cry does not vary in pitch, length and volume to indicate different needs
- Difficulty establishing/maintaining a rhythmical suck/swallow pattern
- Significant loss of breast milk/formula out of side of mouth during feeding
- Inability to establish or maintain face to face communication during feeding
- Does not vocalize in response to sound stimulation
- Has not begun to laugh by 5 months in response to play
- Does not babble during play or in response to stimulation (may suggest hearing difficulties)
- Does not use voice to vocalize attitudes other than crying
- Does not respond to sound stimulation (indicative of hearing difficulties)
- Difficulty with swallowing early solids or other feeding issues
- Does not look towards sounds or own name
- Does not babble double consonants (bababa...)
- Difficulty with textures in foods (gagging, choking, etc.)
- Does not participate in conversations with adults using babbling
- Does not say "mama" or "dada" non-specifically
- Does not use different inflections to produce exclamations
- Unable to successfully eat early finger foods or munch/bite on foods
- Does not babble single consonants such as "ba" or "da"
- Does not respond to words/language appropriately
- Does not experiment with language when playing independently
- Does not participate in conversations by responding with vocalizations
- Does not use inflection during vocalization
- Does not experiment with language during play
- Does not use 1 to 3 words spontaneously while repeating additional words
- Does not vocalize or gesture to communicate needs
- Does not use "no" emphatically and meaningfully
- Does not use exclamatory expression such as "oh-oh", "No-no", Ta-da", etc.
- Does not attempt to sing songs
- Does not use 10-15 words spontaneously
- Does not use vocalization in conjunction with gestures
- Does not use language to communicate needs
- Does not repeat sounds or words or imitating environmental sounds
- Does not jabber tunefully during play
- Continues to demonstrate eating problems (swallowing issues, choking, etc.)
- Does not use jargon with good inflection
- Does not label 2-4 pictures while looking at a book
- Does not put 2-4 words together to form short sentences or communicate needs
- Does not understand nouns, verbs and modifiers an their uses
- Does not use intelligible words to communicate needs
- Does not imitate 2-4 word phrases
- Does not relay experiences using jargon, words and/or gestures
- Does not have at least 50 - 100 words
- Does not sing phrases of songs
- Does not use three word sentences
- Does not use a wide range of consonant and vowel sounds
- Does not use past tense words "He runned"
- Does not express frustration at not being understood
- Does not use up to or more than 50 expressive words
- Does not imitate phrases or experiment with new words
- Words are not clearly articulated
- Does not respond to questions when asked things
- Does not produce correct beginning sounds of words
- Has a hard time understanding prepositions
- Does not speak in complete sentences
- Does not use plurals to refer to more than one (even if not correct)
- Does not participate in storytelling
- Does not have expressive vocabulary of 200 - 1000 words
- Does not use expressive vocabulary to communicate all needs
- Does not use sentences to communicate
- Does not grasp objects placed near palm
- Does not follow an object with her eyes
- Hands remain closed almost all of the time
- Frequently resists being held
- Becomes upset when moved, as when being picked up, laid down, or handed from one familiar person to another
- Does not swipe at or reach for objects
- Does not bring hands or objects to mouth
- Frequently irritable for no apparent reason
- Does not place both hands on her bottle while being fed
- Does not hold their own bottle
- Doesn't smile at their image in a mirror
- Involuntarily drops objects after only a few minutes
- Does not actively grasp large finger foods such as teething cookies when they are placed on the highchair tray
- Becomes excessively and consistently upset by leaving the home
- Does not transfer an object from one hand to the other
- Not beginning to pick up small objects
- Does not poke with index finger
- Does not accept a variety of food textures
- Becomes excessively upset by being dressed, diapered, bathed, or having hair groomed
- Isn't able to pick up a cheerio or other small object with tip of the thumb and the tip of the index finger
- Does not sleep through the night, most of the time
- Does not show interest in exploring toys made for one year olds
- Becomes excessively upset by sounds of sirens, barking dogs, vacuum cleaners, or other familiar loud noises
- Cannot put a one inch object into a container with a slightly bigger opening
- Cannot stack two cubes
- Cannot put a round form into a round shape on a puzzle
- Cannot point to a few of the following body parts: eyes, nose, mouth, hair, tummy, legs, feet, and hands
- Cannot stack four books
- Cannot turn pages of a cardboard book, or regular small book two or three pages at a time
- Plays with toys only by tapping, shaking, or throwing
- Cannot unscrew the top of a one inch or two inch bottle
- Cannot remove socks, untied shoes, or pull on pants without help
- Cannot imitate drawing a vertical line or a circular scribble on paper immediately after seeing an adult draw these lines
- Cannot stack eight to ten cubes
- Cannot imitate drawing a horizontal line immediately after seeing an adult draw a horizontal line
- Cannot remove all pull on clothing after fasteners have been undone
- Does not imitate the actions of adults in the home
- Does not lift head in prone position (while lying on their stomach)
- Does not turn head to one side in prone position
- Does not turn head to both sides in supine position (lying on back)
- Does not hold head up 90 degrees in prone position (lying on stomach)
- Does not extend both legs or kick reciprocally
- Does not roll to back when placed on their side
- Does not place weight on forearms in prone position (lying on stomach)
- Does not rotate or extend head
- Unable to grasp a rattle
- Cannot bring both hands together
- Does not roll over one way
- Does not hold head up when pulled to sitting
- Unable to hold head steady in supported sitting position
- Does not bear weight on legs
- Unable to keep head level with body when pulled to a sitting position
- Does not demonstrate balance reactions
- Cannot bear weight on hands in prone position (lying on stomach)
- Does not move head actively in supported sitting position
- Does not roll over either way
- Does not bear weight on legs
- Cannot lift head or assist when pulled to sitting position
- Demonstrates little balance reactions or protective extension of arms
- Does not roll over both ways
- Cannot sit with little or no support
- Does not hold weight on one hand while in the prone position (lying on stomach)
- Cannot bear weight on legs and bounce
- Cannot get to sitting position without assistance
- Does not assume crawling position (hand-knee position)
- Does not show interest/motivation to crawl
- Cannot sit on own without hand support
- Does not pull to stand using furniture
- Cannot switch positions from sitting to prone
- Does not creep on hand and knees
- Cannot pivot while in sit position to retrieve toy
- Cannot pass an object from one to the other
- Cannot stand holding on to someone or something
- Cannot pick up small objects
- Does not walk with one hand held
- Cannot stand alone well
- Does not demonstrate balance reaction while in kneeling position
- Does not walk alone one to two steps
- Does not demonstrate motor planning by climbing on furniture
- Has a hard time picking up small objects
- Does not attempt to creep upstairs
- Does not walk without support
- Cannot throw ball
- Does not bend down to retrieve objects
- Does not demonstrate balance reaction in standing
- Does not run
- Cannot walk upstairs with one hand held
- Cannot carry a large toy while walking
- Does not squat in play
- Cannot retrieve a toy off of floor from standing position
- Does not climb onto furniture, turn and sit
- Cannot build a tower of six blocks
- Does not use utensils well
- Does not jump in place with both feet
- Does not stand from sitting by rolling on side
- Cannot catch large ball
- Has difficulty with gait and balance
- Does not walk downstairs using rail for support
- Does not have wide range of movement
- Does not run and stop without holding
- Does not avoid objects when running
- Cannot kick stationary ball
- Unable to stand on one foot for two seconds
- Cannot build tower of 9 blocks
- Cannot complete 5-6 piece puzzle
- Does not use utensils properly
- Does not attempt to ride tricycle
- Does not demonstrate grasp of a crayon